Israel 21C–A new, enhanced MRI diagnostic approach is now able to identify significant damage to the blood-brain barrier (BBB) of professional football players following “unreported” trauma or mild concussions. Published in the current issue of JAMA Neurology, this study could improve decision making on when an athlete should “return to play.”
According to Dr. Alon Friedman there wasn’t a diagnostic capability to identify mild brain injury early after trauma. In the NFL, other professional sports and especially school sports, concern has grown about the long-term neuropsychiatric consequences of repeated mild Traumatic Brain Injury (mTBI) and specifically sports-related concussive and sub-concussive head impacts.
The paper, published by Ben-Gurion University of the Negev (BGU) and Soroka University Medical Center, describes a new diagnostic approach using Magnetic Resonance Imaging (MRI) for detection and localization of vascular pathology and blood-brain barrier breakdown in football players.
Study participants included 16 football players from Israel’s professional football team, Black Swarm, as well as 13 track and field athletes from Ben-Gurion University who served as controls. All underwent the newly developed MRI-based diagnostic.
The DCE-MRIs were given between games during the season and revealed significant damage. Forty percent of the examined football players with unreported concussions had evidence of “leaky BBB” compared to 8.3 percent of the control athletes.
“The group of 29 volunteers was clearly differentiated into an intact-BBB group and a pathological-BBB group,” Friedman explains. “This showed a clear association between football and increased risk for BBB pathology that we couldn’t see before. In addition, high-BBB permeability was found in six players and in only one athlete from the control group.”
Friedman also explains that not all the players showed pathology. This indicates that repeated, mild concussive events might impact some players differently than others. This level of diagnosis of individual players can provide the basis of more rational decision making on “return to play” for professionals as well amateurs of any age.
“Generally, players return to the game long before the brain’s physical healing is complete, which could exacerbate the possibility of brain damage later in life,” says Friedman.
Other members of the research team include BGU Ph.D. candidates Itai Weissberg and Ronel Veksler, who developed the new imaging method.
